Organization
ARIZONA DERMATOLOGY SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES O BARLOW M.D. (OWNER/MEMBER)
(602) 793-8411
Entity
Organization
Contact information
Practice address
14800 W. MOUNTAIN VIEW BLVD., STE. 160, SURPRISE, AZ 85374-2700
(623) 584-3376
(623) 584-3375
Mailing address
P.O. BOX 9290, SURPRISE, AZ 85374-9290
(623) 584-3376
(623) 584-3375
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
29708
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
29708
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721358
—
AZ
01
—
P17495542
AZ PLLC REGISTRATION
AZ
Enumeration date
04/02/2012
Last updated
09/04/2012
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